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‘Pharmacy needs better funding to enable integration’

“The opportunities for pharmacy teams in community health improvement are limitless”

Funding issues must be taken seriously before community pharmacy can integrate with other areas of healthcare, says Laura Buckley

Pharmacy may never be the same after the COVID-19 outbreak. Whether we see changes in the public perception of the role of pharmacy teams, or enormous shifts in service provision, the aftermath of the pandemic may make the future of pharmacy very different to how we envisioned it six months ago.

So if anything could change the course of healthcare as we know it, COVID-19 could. In recent months our pharmacy teams have overcome challenges including a lack of personal protective equipment (PPE), medicine shortages, and taking on a delivery service.

We have worked in circumstances so extreme that just last year they would have shocked and horrified us. When the stories we used to hear about practice in other countries became our reality, our teams had no choice but to carry on with business – although this time not as usual. But when the aftermath of the COVID-19 spike has passed, what will our day-to-day work entail?

Leyla Hannbeck, chief executive of the Association of Independent Multiples (AIMp), suggested last month that pharmacies should provide COVID-19 antibody testing as part of the sector’s integration into wider healthcare. It goes without saying that community pharmacies certainly have the capability to provide the service, but do they have the resources? 

The sector is woefully unprepared to provide such a service, which would add to the existing pressures of finding PPE, maintaining staffing levels and sourcing funding.  

But if the sector is granted an improvement of current funding, supported by the Department of Health and Social Care (DH) to provide COVID-19 testing in-house, I believe local pharmacies could soon become testing hubs for their communities.

COVID-19 antibody testing is just a taster of the possible ventures that are being explored for the future of pharmacies. With the focus of primary care networks (PCNs) shifting to care homes, there’s a gap for pharmacists in the community to integrate into multidisciplinary teams in a shared-care approach to enhance healthcare provision for patients.

But again, issues with funding and capacity for extra healthcare provision must be seriously considered if integration is to work well. The opportunities for pharmacists and pharmacy technicians in the improvement of community health are limitless, but very few have shown desire to make a move forward.

The sector has lagged behind in embracing new services, but this is not because pharmacy teams do not wish to improve – a lack of resources holds them back. Discontentment in pharmacy appears to exist because the bodies that represent it have thus far been unsuccessful in pushing the boundaries of its capability.

The belief among pharmacy teams is that they have not secured enough resources to support their workloads This raises the question as to how we can begin to make positive changes even as things stand. Our teams are bruised from the efforts of working through the pandemic, they’ve suffered abuse from the general public and they’ve been disregarded by the government. To insist on more service provision right now is too much to ask.

But perhaps the arrival of COVID-19 marks a plot twist for pharmacy. We can only hope that our efforts in recent months will highlight the versatility and willingness to embrace change of the profession.

Will the pandemic bring us better funding? Will our sector take the lead in community health provision? Will the public finally appreciate pharmacy for what it does? It all feels like a dream beyond the tips of our outstretched fingers. But with a nation in need of healthcare advice and medicines now more than ever, the show must inevitably go on.

Laura Buckley is a locum and PCN pharmacist based in Hull

18 Comments

PRIMARY CARE PHARMACIST, Primary care pharmacist

A colleague has worked in GP practice along side his job as a community pharmacist for many years. He left the CP job in April for a full-time GP practice job as the goodwill from the pharmacy owner for him to continue was no longer there, and CP was becoming a box-ticking exercise instead of a clinical role.  The benefits of the relationship were no longer evident to the owner because of the funding situation, so manager has moved on. Their loss. 

N O, Pharmaceutical Adviser

Pharmacy needs better funding -- FIRST and desperately.

to enable integration -- Let's talk about this and associated funding once the first part is taken care of.

 

A.S. Singh, Community pharmacist

Even as a contractor pre 2015, before the cuts I used to call in my regular locums full time to allow me to develop services and forge good relationships with GPs, attend meetings, do further training etc

The cuts have essentially not allowed contractors (not corporates who pocket the cash) to hire that extra locum. It is not possible to do all the checking and run a business in the current climate in a busy pharmacy without funded help

Kevin Western, Community pharmacist

I can see where this was meant to go and it's largely correct. The desire to change is there, though by no means universal, The resources to actually do it are very very problematic right now.
The "austerity" of Mr Ridge's attempt to lay waste to Pharmacy has removed any capacity to rapidly take on new roles without new money being spent on staffing in Pharmacies first.
The attitude of NHSE toward Pharmacy makes all this harder, with resistance to any change which might make services easier to carry out or even safer for all concerned - what is the justification for refusing to allow nms without written consent? That is pure bullying.

C A, Community pharmacist

For some reason your ending made me think of this - 

"What's this? Will the [DOH] have the last laugh? Are our heroes doomed? Can they get to the bottom of this mystery before they reach the bottom? If not, will this show end early?" To be read in David Jason's voice.

Lucky Ex-Locum, Superintendent Pharmacist

You're showing your age - Dangermouse is voiced by Alexander Armstrong now!

Industry Pharmacist, Head/Senior Manager

Ms. Buckley with yet another deluded article.

Leon The Apothecary, Student

I think Laura does have some really interesting reads. She clearly has a drive to progress Pharmacy, however, I feel that energy would be better served in envisioning Pharmacy through a metamorphosis.

Industry Pharmacist, Head/Senior Manager

Clearly she is highly intelligent and passionate, which is admirable. I apologize to Laura if I came across disrespectful, which was not intended. But I'm afraid, in my opinion, she is far too optimistic and unrealistic about the sector especially community. Conversely, I am happy to admit that I'm old and cynical.

Leon The Apothecary, Student

It's understandable if the system has been pushing back at you for a long time that some healthy pessimism has developed. I'm definitely an optimist myself, and I believe it's important someone reigns our lot in! Keeps us all in balance, right?

Industry Pharmacist, Head/Senior Manager

Indeed. A balance is key.

Lucky Ex-Locum, Superintendent Pharmacist

I disagree. I think Laura's articles are broadly very good, but in this one, I think she is misguidedly optimistic about the prospects for pharmacy. In my opinion, for what it's worth, I don't think pharmacy has a viable future.

Leon The Apothecary, Student

I feel Pharmacy has an identity issue. It provides services like a GP surgery, it distributes medicine like a warehouse, it sells items like a shop, it runs like a business but is funded as a public service.

It is a jack of all trades, it fills up the missing gaps, but does it have a clear definition?

Lucky Ex-Locum, Superintendent Pharmacist

No it doesn't and that is the problem - there is NOTHING we do that cannot be done either somewhere else or by someone else. Even our essential services are only a ministerial penstroke away from being removed. If ACTs can check accuracy, all clinical checks can be done by computer (which they more or less already are anyway) and the RP isn't needed at handover, which all only need small tweaks of legislation, our role becomes redundant.

We need to become a master of one of our trades but which one?

Leon The Apothecary, Student

My personal view is that Amazon is working on their trademark, and considering how they undercut businesses to such an extreme that there is no way to compete, they are likely to steal a massive market share, even if they do it at a loss - it's been their modus operandi since the beginning in multiple sectors.

Pharmacists in the community do best clinically managing and optimising long-term treatment with patients and highlighting when changes need to be made, in my opinion. I see the push to move Pharmacists into GP Surgery to be in line with that.

N O, Pharmaceutical Adviser

""but very few have shown desire to make a move forward""

Desire for what? To provide a tedious service for say £5 with long list of paperwork? Then yes we do not want to move forward.

Cymraeg Locum, Locum pharmacist

"The opportunities for pharmacists and pharmacy technicians in the improvement of community health are limitless, but very few have shown desire to make a move forward."

If you could provide some evidence for this statement, that would be most helpful.

 

Leon The Apothecary, Student

I feel Pharmacy Technicians have leapt in terms of expanding themselves professionally compared to pharmacists. I wish pharmacists had the leadership and momentum to do the same!

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